Children in care - Yet another symptom of huge failure

IT is unfortunate that the Health Service Executive is the focus of a damning report again this morning but the failures uncovered are so great that it cannot be ignored.

The organisation has been continually criticised – justifiably so in too many instances – and this cannot be good for the organisation’s 110,000 employees or how it is perceived.

The vast majority of health workers are committed to providing the best possible care for patients and must be as frustrated as everyone else at the publication of another indictment identifying unacceptable failures.

The HSE catastrophe list is frightening – psychiatric patients in inhuman conditions; life-threatening delays; failures to detect pregnancies; misreading of X-rays; and patients on trollies for days in accident and emergency units. The impact of the reduction in support services for carers and families with children who have intellectual difficulties cannot be underestimated either.

These are just tip-of-the-iceberg issues. There are many, many more, especially in the structure of the organisation. For instance, the ratio of health workers to administrators seems terribly out of kilter.

Today’s report looks at how successful, or, as this research sadly concludes, unsuccessful, crisis intervention in the lives of troubled children has been. In almost half of the cases reviewed by the disbanded Children Acts Advisory Board (CAAB) little or nothing was achieved. In more than one case in five the child’s circumstances deteriorated. Some of these children are the most disadvantaged in society and even at a very early age seem destined to lead troubled and unfulfilled lives.

The deaths of so many children in HSE care has highlighted these issues but even those tragedies did not hint at such a high failure rate. There are many reasons for these failings. Inappropriate structures, staffing levels, the absence of out-of-hours services and the reluctance of some children to engage with a process that might change their lives.

As the rebel Fianna Fáil backbencher Mattie McGrath pointed out at the weekend the HSE has become an unaccountable monster that is not delivering the services expected of it. He suggested that it is time to go back to the drawing board to try to build a health service we can all be proud of.

However it is done these issues must be resolved but whether an increasingly fractious coalition, facing so many other great challenges, has either the will, the energy or the moral authority needed for this huge task is another question those who seem intent on sustaining it must ask themselves.


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